VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 10/01/2021
** VAERS DATABASE Last updated: October 1, 2021**
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Manufacturers

Total Manufacturer
187,133MODERNA
33,878JANSSEN
2,321PFIZER\BIONTECH
1,091GLAXOSMITHKLINE BIOLOGICALS
983UNKNOWN MANUFACTURER
363MERCK & CO. INC.
229SEQIRUS, INC.
45DYNAVAX TECHNOLOGIES CORPORATION
41NOVARTIS VACCINES AND DIAGNOSTICS
29SANOFI PASTEUR
18EMERGENT BIOSOLUTIONS
8PAXVAX
7TEVA PHARMACEUTICALS
4PFIZER\WYETH
3BERNA BIOTECH, LTD.
2SMITHKLINE BEECHAM
2INTERCELL AG
2PROTEIN SCIENCES CORPORATION
1CSL LIMITED

Incidents per State

State Total
77,548
AK1,869
AL5,581
AR3,688
AS47
AZ14,288
CA61,984
CO11,665
CT8,149
DC1,663
DE1,807
FL37,749
FM5
GA15,058
GU120
HI2,453
IA4,625
ID2,692
IL20,334
IN24,007
KS4,615
KY7,696
LA4,887
MA14,654
MD12,514
ME3,129
MH11
MI18,739
MN12,528
MO9,710
MP29
MS2,790
MT2,375
NC16,368
ND1,356
NE2,880
NH3,100
NJ17,634
NM3,916
NV4,239
NY34,355
OH19,081
OK6,195
OR8,636
PA23,083
PR2,370
QM2
RI2,088
SC6,411
SD1,212
TN9,131
TX35,174
UT4,273
VA14,937
VI64
VT1,676
WA14,909
WI11,259
WV2,388
WY861
XB5
XL1
XV2

ID: 0992606
Sex: F
Age: 85
State: WI

Vax Date: 01/28/2021
Onset Date: 01/30/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA? Presents to the emergency department with syncope. Patient received her 1st dose of the COVID-19 1/28/21. She states she felt in her normal state of health yesterday. However, she was unable to sleep at all overnight. She took a nap between 5 a.m. and 9 a.m., Upon waking this morning, patient states she felt generally fatigued, had nausea with associated diffuse abdominal pain. Patient had 1 episode of emesis. No hematemesis. Immediately following emesis, she describes 1 to 2 episodes of syncope that occurred while she was seated in a chair. Patient did not fall or strike her head. She denies preceding chest pain, shortness of breath, back pain, numbness, tingling, weakness. Per EMS, patient was awake, somnolent but oriented, with stable vital signs including heart rate of 68, respiratory rate of 18, pulse ox of 90% on room air and blood pressure of 126 systolic. On arrival to the ED, patient appears somnolent, hemodynamically stable with normal blood pressure, afebrile. Patient feels symptomatically improved after 1 L normal saline bolus and Zofran. She was discharged home in stable condition.

Other Meds:

Current Illness:

ID: 0992607
Sex: F
Age: 33
State: CA

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Sore arm, itching around injection site, headache localized in the back of my head, and stiff neck

Other Meds: NA

Current Illness: None

ID: 0992608
Sex: F
Age: 88
State: TX

Vax Date: 01/19/2021
Onset Date: 01/28/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa, Codeine, Penicillin

Symptom List: Chest discomfort, Dysphagia, Pain in extremity, Visual impairment

Symptoms: On 1/28/21, resident complained of "itching" on her trunk. Upon assessment by R.N., resident was found to have a rash, suspicious of shingles. A telehealth visit was performed with her primary care physician's office Dr. wherein she was diagnosed with shingles. She was prescribed Valacyclovir HCl 1 gm 1 bid x 7 days and Gabapentin 300 mg 1 q day.

Other Meds: Fexofenadine 60 mg 1 prn; colace 100 mg 1 q day prn; Immodium 2 mg 1 q 3hrs prn; Pristiq 50 mg 1 q day; Losartan 100 mg q day; Xarelto 10 mg 1 q day; Donepezil 10 mg 1 q day; Lasix 40 mg 1 q day; Atenolol 25 mg 1 bid; Tylenol 500 mg 1 q 6 h

Current Illness:

ID: 0992609
Sex: F
Age: 57
State: CA

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies: Penicillin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: I had extreme pain in my shoulder at the vaccine site; then I had extreme pain - my whole upper back (especially my right side) - like someone had taken a hammer and beaten my back. I exercise a lot and I'd exercised cross country skiing and downhill skiing the day of the vaccine and the next day I worked. I could barely use my right arm to treat my patients. I was sore and as the days went on I was really fatigued. I felt like I had a low grade fever. I usually have lower than normal temperature and it was 99.4-99.7 range. So on Monday I called the Occupational Health Dept of the Hospital - and they told me stay off work. And they had me test for COVID - negative. It took about a week until I started to feel better. To treat during the course of it I just took Advil. Recovered before my second dose on January 20th, 2021. I did not exercise before that second dose vaccine or work the next day and I stayed very hydrated and went into it rested.

Other Meds: no

Current Illness: no

ID: 0992610
Sex: M
Age: 86
State: NY

Vax Date: 01/29/2021
Onset Date: 01/31/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Swelling under left armpit. Small 1/30/2021, enlarged to 2? diameter today2/1/2021. No pain, but mild discomfiture when I lift arm, or press on it.

Other Meds: LEVOTHYROXIN Eliquis Metoprolol Furosemide Flovent inhaler Vit B12 Multivitamin

Current Illness:

ID: 0992611
Sex: F
Age: 78
State: WA

Vax Date: 01/24/2021
Onset Date: 01/24/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: erythromycin

Symptom List: Chills, Confusional state, Eye inflammation, Headache, Laboratory test

Symptoms: pt states the area around injection site is red and swollen about 3 1/2 inches in size and very painful. Left leg is swollen on the front of the leg about 8" in size. Pt called PCP and was told to take Benadryl.

Other Meds: cartia 180mg, tymlos injection daily, prolia every 6 mo, fish oil, gabapentin, Vitamin C,D, B12

Current Illness: none

ID: 0992612
Sex: F
Age: 55
State: IN

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Yes

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Started as headache within 1 hour. Progressed to body aches within 12 hours. No sleep due to aches. Took 2 Aleve/Naproxen. By morning, developed low grade fever, had numbing/tingling in left cheek and very uncomfortable. By 8 AM, called doctors office due to numb/tingling in cheek and fever. Went to doctor's office. Was given Naproxen 500 mg and other meds for other medical conditions that were not an issue prior to this situation. This situation exacerbated my other medical issues.

Other Meds: None

Current Illness: None

ID: 0992613
Sex: F
Age: 56
State: NC

Vax Date: 01/16/2021
Onset Date: 01/17/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NSAIDs, gluten

Symptom List: Pharyngeal swelling

Symptoms: Fatigue lasting 6 days, swelling in the joint of my left thumb. As of 2/1/2021, the swelling has not diminished.

Other Meds: baclofen, advair hfa, albuterol, zyrtec, pepcid ac, vitamin D, adderall XR, sumatriptan, nasocort nasal spray, magnesium, CoQ10, emgality

Current Illness: none

ID: 0992614
Sex: F
Age: 58
State: CA

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Chill, fatigue. Numbness on her face. Massive Cole sore on left side of her face. Head ache behind left eye.

Other Meds:

Current Illness:

ID: 0992615
Sex: M
Age: 40
State: TX

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Diarrhoea, Nasal congestion

Symptoms: 30th January 2021-Am-rash-size od baseball, chills, HA-is this his from his tooth or COVID-19-he wonders, PM-freezing & hot body. 31st January 2021-more of the same-chills, HA, hot body- freezing, rash still present on his left deltoid area 1 February 2021-less chills, moving slowly, Left deltoid less hot, not as freezing Taking Tylenol, motrin. Reminded IF he gets worse-go to the ER. Reminded him-does he need to contact his PCM-do so.

Other Meds: Hydrocodone-PRN hasn't used-had a tooth pulled Tylenol, motrin

Current Illness: Had his tooth pulled first week in January 2021

ID: 0992616
Sex: F
Age: 66
State: WI

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: penicillin, soy

Symptom List: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: Second vaccine Lot Number - EL3248 . 1/19/2021. Twitches in the left calf on the back. Then went to the upper leg. Short pains then they would come and go. Then the pain went to the right leg. Numbness under the left knee. Feel like her calf is full. Going to see a neurologist.

Other Meds: Didn't want to provide RX info

Current Illness: no

ID: 0992618
Sex: F
Age: 32
State: IN

Vax Date: 01/30/2021
Onset Date: 01/31/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: Sulpha drugs

Symptom List: Rash, Urticaria

Symptoms: Moderate Fatigue, extreme muscle soreness and loss of range of motion, pain at injection sight, mild headache

Other Meds: L-lycine , vitamin D , Liletta iud, centrum 21 , Claritin

Current Illness: None

ID: 0992619
Sex: F
Age: 42
State: CA

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: FEVER, CHILLS, SHAKINESS, NAUSEA BODY ACHES DIARRHEA RESTLESS, DIFFICULTY SLEEPING SWELLING AT INJECTION SITE

Other Meds:

Current Illness:

ID: 0992620
Sex: F
Age: 59
State: AL

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: PERCOCET, PENICILLIN

Symptom List: Dyspnoea, Fatigue, Feeling abnormal, Head discomfort, Headache

Symptoms: PT C/O REACTION AROUND 5 HOURS AFTER ADMINISTRATION. ADVERSE EVENTS INCLUDE: ARM SWELLING AT SITE, KNOT AND BRUISING AT SITE, JOINT PAIN, URINARY INCONTINENCE, FATIGUE, HEADACHE, MUSCLE PAIN

Other Meds: VITAMIN D, METOPROLOL

Current Illness: POSITIVE COVID 19 RESULT 1/08/2021

ID: 0992621
Sex: F
Age: 48
State: OR

Vax Date: 01/22/2021
Onset Date: 01/30/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulpha, sulfa

Symptom List: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: "Covid arm". 8 days after the vaccine, at injection site, red swollen, itchy. burning. Hot to the touch. Large red area. Sore muscle in left arm. No fever. Lasted about 2 days and is starting to go away on its own

Other Meds: Vitamin D, Lexapro, vitamin, elderberry, NP Thyroid, atarax

Current Illness:

ID: 0992622
Sex: F
Age: 79
State: CA

Vax Date: 01/19/2021
Onset Date: 01/28/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Metronidazole (hives), sulfa antibiotics (hives), mango (angioedema, rash), Band-Aid adhesive (rash).

Symptom List: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Developed approx. 3cm rash on 1/28 at the site, then the rash spread locally. Still has rash at the time of reporting on 2/1/20. No other systemic symptoms.

Other Meds: Citalopram 20mg 1 tab daily, Levothyroxine 100mcg 1 tab daily, Ambien 5mg 0.5 tabs at bedtime as needed for sleep (three times a week on average), Vitamin D 1000 international units a day,

Current Illness: none

ID: 0992623
Sex: F
Age: 26
State: LA

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: Clindamycin, Lincomycin, hydromorphone

Symptom List: SARS-CoV-2 antibody test, SARS-CoV-2 test negative

Symptoms: Following 1st COVID-19 vaccination she began having generalized fever, body aches, fatigue, and near syncope prompting her to go to the ED, 2 days after the vaccine. She also began having diffuse swelling of the LUE and L chest wall. Swelling down to elbow prior with erythema and mild rash, which I visualized in a photo. Unsure if blanched. Resolved over several days and was without symptoms when I saw her. Had IV in AC area for IVFs on impacted side but denied symptoms of infiltration.

Other Meds: None

Current Illness: none

ID: 0992624
Sex: F
Age: 87
State: WA

Vax Date: 01/23/2021
Onset Date: 01/24/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: HIBV
Manufacturer: MERCK & CO. INC.
Vax Name: HIB (PEDVAXHIB)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: Tetanus vaccine, travoprost

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Localized erythema edema pruritic skin on the inoculated shoulder and arm

Other Meds: Cimzia, indapamide, methotrexate, telmisartan, b complex, vitamin c

Current Illness: none

ID: 0992625
Sex: F
Age: 67
State: TX

Vax Date: 01/30/2021
Onset Date: 01/30/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: PNC13
Manufacturer: PFIZER\WYETH
Vax Name: PNEUMO (PREVNAR13)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Moderna COVID-19 Vaccine EUA January 30, 2021--Received vaccine at 9:45 a.m. Noticed soreness in arm at 1 p.m. At 2 p.m. felt sluggish decided to take a nap (arm began to hurt); 5:30 p.m. noticed large red rash with egg size knot under skin. Skin was hot to the touch and itching ensued. January 31-- 2:03 p.m. In pain and rash was itching terribly bad. Called the pharmacist (since this was weekend). Pharmacist suggested liquid Benadryl for itch, hydrocortisone cream, Tylenol, and a cold pack. Took photo progression from January 30 thru today, February 1 -- rash is still visible and itching but thinning; knot is smaller but still there; arm is stiff--but better.

Other Meds: Estradiol-2mg, Ocuvite eye vitamin, Caltrate 600 + D3, Centrum Silver, Loratadine 10 mg, Vitamin C 250 mg, Vitamin D3 50 mcg, Zinc 50 mg, Cranberry 4200 mg, Biotin, 10,000 mcg, Renew Life Extra Care Probiotic 30 billion live cultures, Reph

Current Illness: None

ID: 0992626
Sex: F
Age: 64
State: IN

Vax Date: 01/30/2021
Onset Date: 01/30/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: RV1
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: ROTAVIRUS (ROTARIX)
Lot:
Dose Series: 1
Vax Route: PO
Vax Site: MO

Lab Data:

Allergies: sulfa tomatoes, peanuts

Symptom List: Blood pressure increased, Chest discomfort, Heart rate increased

Symptoms: sat. at 10:30pm to sun. 5:30am- chills/fever- felt like run over by train Sun. fever all day with tylenol- highest 101.8- very fatigue Mon. am felt better, afternoon around 2pm feeling flushed temp 100.3, tired

Other Meds: olmesartan/hctz, lovastatin. omeprazole

Current Illness:

ID: 0992627
Sex: F
Age: 44
State: AR

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Toradol mobic most anti-inflamatories latex

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Lymph node pain, Lymphadenopathy

Symptoms: Severe lethargy for about 12 hours, severe abdominal cramping for about 72 hours Moderate-severe arm pain at injection site and all down arm for about 24 hours

Other Meds: A ciphex. Wellbutrin Pristique calcium with vitamins D

Current Illness: None

ID: 0992628
Sex: M
Age:
State: AZ

Vax Date: 01/26/2021
Onset Date: 01/28/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NA

Symptom List: Unevaluable event

Symptoms: Injection site pain for 3 days, headach 24 hours, chills 24 hours, fever 24 hours 101.8, Nausea 24 hours, feeling unwell 24 hours

Other Meds: Levemir, Farxiga, Humulin, Metformin, Lisinopril, Prazosin, Omeprazole, Vit.D-3, Dicyclomine. Lactobacillus, Aspirin, B-12, CoQ-10, Emergen C Triple Omega, Garlic

Current Illness: COVID and Pneumonia

ID: 0992629
Sex: F
Age: 37
State: IL

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: Pain at injection site started the day after vaccination (1/23). On 2/1, she noticed a bullseye rash to injection site along with intense pain and itching. She then noticed elevated heart rate and began to feel light headed. She was instructed to go to the emergency department at our local hospital . Her heart rate was 107 and blood pressure was 162/112. An IV was started and IV Solumedrol and Benadryl were administered. Chest X-Ray revealed pneumonia. Bloodwork is pending.

Other Meds: Lisinopril, collagen, loratadine, cytolopram, vitamin C, Zinc

Current Illness: None

ID: 0992630
Sex: F
Age: 42
State: AZ

Vax Date: 01/30/2021
Onset Date: 02/01/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None known

Symptom List: Injection site pain, Pain

Symptoms: Nausea, Headache

Other Meds: Lithium, lamotrigine

Current Illness: N/a

ID: 0992631
Sex: F
Age: 36
State: SC

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Biaxin

Symptom List: Injection site pain, Menorrhagia

Symptoms: Localized reddened area, about the size of a quarter accompanied by itching, swelling, pain at site, and warm to touch. Employee applied ice and continued to monitor site. No additional rashes noted and rash didn't spread any.

Other Meds: Novolog, Desvenlafaxine, Singular, zyrtec, Vitamin D, Atorvastatin, Kaitlib Fe, Propranolol

Current Illness: NONE

ID: 0992632
Sex: F
Age: 62
State: CA

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: NKA

Symptom List: Arthralgia, Chills, Headache, Mobility decreased, Myalgia

Symptoms: The vaccine was injected too high in left arm. I know this because I am a retired pharmacist and when I removed the bandage noticed injection was near the shoulder and not in the mid deltoid area. The left arm/shoulder began to feel sore in the evening and was very sore the next day. Was unable to lift arm or move without pain. Over the next several days the severe pain decreased, but I continue to have pain in the arm, especially the bicep area. Range of motion is limited. Severe pain when trying to lift my arm from resting position while in bed. Severe pain when rotating arm inward. Pain occurs with certain movements.

Other Meds: Omeprazole

Current Illness: GERD

ID: 0992633
Sex: F
Age: 31
State: TX

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Sudden onset of sharp, acute pain to right shoulder(arm vaccine received). Unable to move arm against gravity for 12-24 hours post vaccine. Continued pain to right shoulder, 1 month post vaccine (sharp, acute muscular-type pain). ***Vaccine administered very high in shoulder, higher than any other shot received prior*** Treatment: Rest as able Outcome: Some decreased pain, however still present with certain RUE (right arm) movements

Other Meds: Cabergoline

Current Illness: None

ID: 0992635
Sex: F
Age: 72
State: WY

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Compazine and phenergan

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: I asked her to wait 30 minutes due to her other allergies and right at 30 minutes after the vaccine injection she reported "feeling strange with a little pressure in her chest. 11:30 B?P 180/100 pulse 80 resp 20 she was alert and oriented 11:40 B/P 170/100 pulse 80 Resp 16 alert and oriented. 11:43 she too Nitroglycerine 0.4mg sublingual - She had this in her purse and followed it up with 2 aspirin 81mg and she chewed these. Ambulance had been called due to the history of CAD and HTN and they arrived at 11:47 . They took her B?P and it was 160/110 and the decision was made to transport her to the hospital for further assessment.

Other Meds: none

Current Illness:

ID: 0992636
Sex: F
Age: 45
State: TX

Vax Date: 12/22/2020
Onset Date: 01/05/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: nkda

Symptom List: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Patient started she had numbness to tongue area and HA to frontal lobe. Taste to food was different and the continues of HA and numbness sensation during the day/ evening. She was unable to close her R eyelid and R side drooping. The HA increased with time after two weeks the R side of the face different mouth and R side was swollen. She then seek medical treatment at the ER where she received prednisone and valacyclovir for one week treatment.

Other Meds: amlodipine, vit d

Current Illness: n/a

ID: 0992637
Sex: F
Age: 55
State: IN

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: no

Symptom List: Nausea

Symptoms: Horrible headache followed with chills, body aches and fever. Headache lasted a couple of days.

Other Meds: Effector, Lisinopro, Ropineral

Current Illness: none

ID: 0992638
Sex: F
Age: 69
State: IL

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none (metal against skin, except gold and platinum)

Symptom List: Injection site pain

Symptoms: Day of injection: Slight headache about 90 minutes after injection. Came and went. No medicine taken. Wave of nausea lasting about 15 minutes later in the evening. 2nd day: Arm soreness. Feeling in my chest as though I needed to take a deep breath, on and off throughout the day. Heart rate fine, blood pressure good (125/70 average), blood oxygen 97-99 all day, evening. 3rd day: arm soreness diminished. No other side effects.

Other Meds: Propafanone Enalapril aspirin fish oil calcium + D Flonase Xanax

Current Illness: none

ID: 0992639
Sex: F
Age: 69
State: MD

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Fever to 102.4. Chills. Shaking. Generalized body aches. Injection site pain down arm. Tachycardia of 120 beats per minute. Pulse ox was 96%. Weakness. Nause

Other Meds: Finasteride Synthroid Thymosin alpha 1

Current Illness: None

ID: 0992640
Sex: F
Age: 71
State: WA

Vax Date: 01/20/2021
Onset Date: 02/01/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Penicillin

Symptom List: Chills, Dizziness, Nausea, Pain, Tachycardia

Symptoms: Rash, swelling, hot to touch at injection site

Other Meds: Levothyroxine Amlodapine Metformin

Current Illness:

ID: 0992641
Sex: M
Age: 45
State:

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa, Seasonal

Symptom List: Tremor

Symptoms: states his 30 minute wait was over and noticed that his cheeks hurt, removed mask and has bright red rash on both cheeks about 3 inches diameter. States that it burns. No rash on arms, chest, back. States throat feels fine and has no difficulty swallowing. O2 99% on r/a, HR 86; BP 138/88 3:35 gave patient 25mg benadryl tablet by mouth - continues to deny throat itching or swelling. Gave patient ice for comfort to hold on cheeks. States" that feels so good. " 3:55 HR 82; O2 97%; BP 122/88 4:00 states he is feeling better that the burning sensation is gone, rash not as red on cheeks. Left ambulatory to personal vehicle.

Other Meds: metformin, zyrtec, lisinopril, trazadone

Current Illness: none

ID: 0992642
Sex: M
Age: 75
State: MN

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 02/01/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: PCN

Symptom List: Erythema, Pruritus

Symptoms: Increased hand and arm tremors, Elevated FSBG (>500) Nausea, decreased mobility, increased confusion, sore throat with Inability to eat or drink

Other Meds: EC ASA 81, Tylenol ES, Atorvastatin, Carbadopa - Levodopa, Magnesium, Vitamin D, Senna, Jardiance, Metformin, Lantus Insulin.

Current Illness:

ID: 0992643
Sex: F
Age: 29
State: NY

Vax Date: 01/18/2021
Onset Date: 01/25/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies: Clindamycin

Symptom List: Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling, Myalgia

Symptoms: I began noticing a rash of red itchy bumps on the 25th of January. It covers my entire body. I am unsure if it is a delayed reaction to the COVID-19 Moderna vaccine or not, It has lasted over a week and has not cleared up.

Other Meds: Calcium with vitamin D

Current Illness: N/a

ID: 0992644
Sex: F
Age: 36
State: OR

Vax Date: 01/23/2021
Onset Date: 01/31/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillins ; Seasonal allergies but none severe

Symptom List: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Dizziness and headache immediately following the vaccine on 1/23/2021, this resolved in a few hours. Small, splotchy redness occurred around the injection site 24 hours later but disappeared the next day. On 1/31/2021 (8 days post vaccine) redness/itchiness/swelling occurred near the injection site (immediately below) and grew in size to approx 3 inches long and 2 inches wide, became warm and raised by the evening of 1/31/2021 and remains this way today 2/1/2021. Appears like cellulitis but no other symptoms and does not appear to be growing in size as of now.

Other Meds:

Current Illness: None

ID: 0992645
Sex: F
Age: 44
State: AR

Vax Date: 01/18/2021
Onset Date: 01/18/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Toradol anti-inflammatory other than diclofenac topical. Latex

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Debilitating lethargy and body aches for 72 hours. Severe arm pain at sight and down arm for 48-72 hours. Moderate dizziness for 72 hours

Other Meds: Wellbutrin pristique aciphex calciu w/vitamin d

Current Illness: None

ID: 0992646
Sex: F
Age: 24
State: UT

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Injection site erythema, Injection site pain, Injection site swelling

Symptoms: After second COVID vaccine, patient had nausea, lightheadness, and newar-syncopal event. Patient went to the ED for further monitoring and labs were drawn. Patient then discharged from the ED.

Other Meds: escitalopram

Current Illness: none

ID: 0992647
Sex: F
Age: 51
State: CA

Vax Date: 01/17/2021
Onset Date: 01/17/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Meperidine

Symptom List: Chills, Feeling cold, Feeling hot, Myalgia, Pain

Symptoms: Most Bothersome is "brain fogginess " for 12 days. Others - fever - 1 day ; myalgia, fatigue, malaise

Other Meds: Albuterol PRN / Multivitamins / Calcium

Current Illness: Intermittent Reactive airway Disease requiring Inhalers

ID: 0992648
Sex: M
Age: 50
State: CA

Vax Date: 01/15/2021
Onset Date: 01/23/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: raw eggs, other food products, chicken derived medications

Symptom List: Pain in extremity

Symptoms: Rash about 8 days after vaccine

Other Meds: Vitamin C, MVI, calcium

Current Illness: none

ID: 0992649
Sex: M
Age: 70
State: LA

Vax Date: 01/08/2021
Onset Date: 01/14/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Abnormal behaviour, Adverse reaction, Anger, Asthma

Symptoms: The patient is a 70-year-old male who presents to the emergency department with complaints of onset of right facial droop and numbness which began approximately 1 hour prior to arrival. No prior similar episodes. Patient does have a prior history of CVA. Denies any focal weakness to his extremities. Denies headache. Denies visual changes. Wife states he might have slight slurring of speech. Patient does have a history of atrial fibrillation and is on Eliquis. Took his Eliquis this morning. Denies nausea or vomiting. Denies chest pain or shortness of breath.

Other Meds: acetaminophen (TYLENOL) 325 MG tablet aspirin (ECOTRIN) 81 MG EC tablet Bifidobacterium infantis (ALIGN ORAL) famotidine (PEPCID) 10 MG tablet fish oil-omega-3 fatty acids 300-1,000 mg capsule FLUoxetine (PROZAC) 10 MG capsule glucosa

Current Illness:

ID: 0992650
Sex: F
Age: 37
State: NH

Vax Date: 01/31/2021
Onset Date: 01/31/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Never

Symptom List: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Extreme fatigue, sore body & joints feel weak, nausea and temp if 100.6

Other Meds: None

Current Illness: None

ID: 0992651
Sex: F
Age: 31
State: IL

Vax Date: 01/09/2021
Onset Date: 01/10/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: penicillin, amoxicillin, codeine, fentanyl, bee stings

Symptom List: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: jan10 @ 1030 pm at rest HR elevated 110-120, flushing, chills( shaking), feelings of anxiety attack, lasted 10-15 mins, took tylenol jan 10 @ 0000 elevated HR 110-120 at rest, flushing, feeling anxious, tongue swollen, took benadryl event stopped and was able to go back to sleep jan 11- notifed my primary care physician he said to continue benadryl three times a day for three days. jan 12 @ 11 am hr elevated 130-140 at rest, flushing, went to ER. in ER ( waited an hr to be seen ) hr back to 80/90s, nml ekg, nml labs ( cbc,tsh, pregnancy test negative,mag) sent home with possibly take prednisone only if hr elevation continued but didnt want to decrease effects of vaccine ( I did not take the prednisone but did pick it up from walgreens) jan 15 went to primary care doctor because my baseline hr seemed higher than normal was ranging 80/90/100 at rest my normal is more 60-80 at rest. primary care physician said not to get the second dose I did have an allergic reaction and to start taking naproxen 500 mg twice daily. Also recommended doing a holter monitor to monitor hr for two weeks. Ekg in the office was normal. feb1st- started two week holter monitor

Other Meds: prenatal vitamin

Current Illness: was sick on dec 27-jan2 was twsted for covid was negative as well as daughter negative for flu,strep, and covid. felt 100% better going in for vaccination.

ID: 0992652
Sex: F
Age: 65
State: CT

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Sulfa drugs; lactose intolerant; gluten sensitivity

Symptom List: Vomiting

Symptoms: For about 30 minutes I felt very jittery, as if I had had way too much caffeine.

Other Meds: Est-ring, glucosamine with chondroitin, vitamin D3, AREDS, calcium

Current Illness: None known, but I have been feeling tired lately.

ID: 0992653
Sex: M
Age: 1
State: AZ

Vax Date: 01/28/2021
Onset Date: 01/30/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Within a few hours of vaccination, Luke developed a fever and muscle rigidity that lasted 48 hours. On 1/30 he developed a small red raised rash on his face, trunk (front and back), legs, and arms. As of today, 2/1, he has had 2-3 episodes of diarrhea every day starting on 1/30. (I am unsure of the type and manufacturer of the Hep A and flu vaccines he received)

Other Meds: None

Current Illness: None

ID: 0992654
Sex: F
Age: 35
State: MA

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Soy and rice . I had an allergic response to rituximab

Symptom List: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: My throat tightened a little 5 min after injection and subsided 25 min after injection. I had hives following injection (2-3) and the hives increases (5-6) and have lasted for 4 days now. It has turned into hives/rash

Other Meds: None

Current Illness: None

ID: 0992655
Sex: F
Age: 61
State: AZ

Vax Date: 01/04/2021
Onset Date: 02/01/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Swelling around eyes.

Other Meds: None

Current Illness: None

ID: 0992656
Sex: F
Age: 52
State: CA

Vax Date: 01/15/2021
Onset Date: 01/16/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: Arm pain, fever, chills

Other Meds: Hydrochlorothiazide, aspirin

Current Illness:

ID: 0992657
Sex: F
Age: 49
State: NY

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Hot flush, Myalgia, Nausea, Tension headache

Symptoms: Allergic Reactioin. Tightening in the throat, urticaria, respiratory distress, swelling of lips/tongue

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm